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, ' �,, <br /> ; <br /> � � . �: ,s ���co courvrY, �L�RIDA <br /> y Permit No. 1���`� <br /> Date Permitted <br /> , �� ( ' <br /> Builder Name/Owner Name ��E� l�6�,/e T�trfYrtC, Control # <br /> County Parcel No. 3�25-2/- D) 70�- (7O0C3d.� 2�Zo SubDiv: C� rr4vlc� �sr;Z�� <br /> Address/Location _� 7J� � g �'��-�,� �u�,`S � 11�, �_ 2� Z <br /> Classification/Type of Use /`�(p�;.�e �Wte �(� ��,�� <br /> TRANSpORTATION IMPACT FEE . Rate: Sq Ft Unit; 1�5 (2 <br /> Exempt [] Yes � No HaW Determined <br /> � Impact Fee Amount $ 3 �32. O v Zone No. TqZ; <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ _�� <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes [] No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credlt Land Total <br /> Recreation Account Rec�eation Credit Recreation Total <br /> Zone TOTAL AMOUNT � <br /> � 5 73• '7�3 <br /> Exempt � Yes � No How Determined ' <br /> LIBRARY F�E <br /> l.and Account �.and Credit Land Total <br /> Facility Account Faciljty Credit <br /> Facility Total <br /> Exempt [] Yes � No How Determined <br /> Total Amount �`�� <br /> RESOURCE FEE <br /> TOTAL AMaUNT ERU <br /> Prepared By , � Checked Sy <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTIQN <br /> PER�ORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> RECEIPTED FOR BY q CENTRALEP RMII'TT NG OFFICE OF <br /> PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrenoe,but simply recelpt of a copy of thls form,plaGing <br /> the building psrmlt owner on notice of thls assessment and th�condilions uf payment for same, <br /> DATE <br /> R�CEIVED BY <br /> RECEIPT NO. DATE <br /> BY <br />